Automated BP vs Manual BP Measurement: Which is Better? (Part 1 of 2)

What’s a clinician to do? Debates about clinical trials, patient populations, and statistical analyses can seem hollow and distant when looking at an anxious patient in an exam room. At that moment, all that matters is what’s best for your patient. Yet clinically relevant data, and more importantly, rigorous discussion of that data, is the means to the end. Professional clinicians quite often need the former in order to effectively deliver the latter. To wit, two similar journal articles were recently published that arrived at two very different conclusions. Let’s take a look:

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Instrument Calibration Adds Error Potential in Manual BP Measurement

In previous posts, we have reviewed the 10 Steps to Accurate Manual Blood Pressure Measurement and 10 Factors That Can Affect Blood Pressure Readings.  As important as these details are, accurate measurement also requires two things:

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Physician Acquired Blood Pressure Measurement is Higher than Nurse Acquired BP

There are several different types of mild and/or episodic hypertension that ambulatory blood pressure monitoring (ABPM) can help a physician diagnose. However, the summary data that ABPM provides, the average daytime or 24-hour blood pressure as two examples, provides significantly different information than the one or two measurements taken in a clinic. Although this difference is one of the reasons that ABPM correlates better to cardiovascular outcomes than in-clinic BP, making it the gold standard for BP measurement, there are few detailed guidelines on the targets or thresholds for ABP like there are for in-clinic BPs like the popular 120/80 as a threshold for normal BP and 140/90 for hypertensive.*

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ASH 2010: A Focus on Improving Blood Pressure Measurement Technique

At the recent 25th annual scientific meeting for the American Society of Hypertension, there was a new program track targeted specifically to clinicians in primary care. The aim was to present the latest hypertension strategies and guidelines in a format that would be appropriate for the primary care physician but also for physician's assistants, nurse practitioners as well as seasoned hypertension specialists. While the session covered various current issues related to hypertension, one clear area of attention was a re-focus on blood pressure measurement methods.

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Wrist versus Upper Arm Blood Pressure Measurement

Is wrist BP an acceptable way to guide treatment for obese patients?

For over 100 years, upper arm blood pressure (BP) measurement has been the gold standard method to guide treatment decisions. This is the recommended technique by both the American Heart Association (AHA) and the European Society of Hypertension (ESH).

For almost nearly as long, it has been well documented that inappropriate sizing of blood pressure cuffs can contribute significantly to errors in blood pressure measurement. Of the most common errors is "undercuffing", which occurs when using cuffs that are too small or too narrow for the patient's arm circumference.

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Back to the Basics of Blood Pressure

Almost everyone knows that blood pressure is one of the most important measurements in medicine. Every time a patient visits a physician's office or hospital, one of the first measurements taken is their blood pressure. Since blood pressure plays such a vital role in monitoring a person's overall health, I thought I would write about the basics of blood pressure and some of the terminology used in blood pressure measurement.

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Will My Cuffs Work on Different BP Monitors?

If you are a professional in the medical field, you know there are many different blood pressure device and cuff manufacturers in the market (e.g. GE, Welch Allyn, CasMed, Trimline, etc). You would also know that it is common for hospitals and physician's offices to use one manufacturer's blood pressure device and use a different manufacturer's BP cuffs. As a manufacturer of both blood pressure monitors and blood pressure cuffs, a common question we receive is "Will the BP cuff I am currently using work with a SunTech blood pressure monitor?"

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